OBJECTIVE: To present the first known case of a viable triamniotic/monochorionic triplet pregnancy case after single embryo transfer.DESIGN: Case Report.MATERIALS AND METHODS: A 35-year-old Gravida 1 Para 1 with approximately one year of secondary infertility. Her husband has a history of mild male factor. Her first baby was conceived on the fifth cycle of controlled ovarian hyperstimulation (COH) with intrauterine insemination (IUI). She generally had generated one to three mature follicles at the time of HCG trigger with aggressive doses of gonadotropins (300 to 450 IU daily). The patient breastfed for one year and then began to pursue fertility in 2004. She had an elevated day 3 FSH (12 mIu/mL) in September, 2006. She completed two additional cycles of COH/IUI cycles prior to proceeding to IVF/ Intracytoplasmic Sperm Injection (ICSI) treatment. She received 7195 IU of gonadotropins with a GnRH antagonist protocol. On October 12, 2006 three ova were retrieved. Post wash semen sample revealed 14 million spermatozoa/mL, with 35% progressive motility, with < 5% normal morphology. ICSI was performed on two metaphase-2 oocytes (the third oocyte was atretic). One two-pronuclear embryo was observed 18hrs post-ICSI. The embryo was cultured in Life Global medium with 5% Serum Substitute Supplement (SSS, Irvine Scientific, Cat #99193) and 3% Human Serum Albumin (HSA, Irvine Scientific, Cat#9988). One four-cell good quality embryo was transferred following assisted hatching (with acid Tyrode's solution) 47 hours post ova retrieval.RESULTS: The patient's serum hCG level was 120 mIU/ml on 10/26/2006, twelve days after embryo transfer. On 12/04/2006, at 9 weeks 3 days gestation, a transvaginal ultrasound confirmed a triamniotic/monochorionic triplet pregnancy, each with fetal cardiac activity. The patient subsequently delivered monozygotic female triplets on May 20, 2007 at 33 weeks and 3 days gestation via cesarean section. All three infants were eventually discharged in good condition and have had no identifiable neurological or physical abnormalities.CONCLUSIONS: To our knowledge, this is the first known case of viable triamniotic/monochorionic triplet pregnancy following a single embryo transfer in IVF-ET. OBJECTIVE: To present the first known case of a viable triamniotic/monochorionic triplet pregnancy case after single embryo transfer. DESIGN: Case Report. MATERIALS AND METHODS: A 35-year-old Gravida 1 Para 1 with approximately one year of secondary infertility. Her husband has a history of mild male factor. Her first baby was conceived on the fifth cycle of controlled ovarian hyperstimulation (COH) with intrauterine insemination (IUI). She generally had generated one to three mature follicles at the time of HCG trigger with aggressive doses of gonadotropins (300 to 450 IU daily). The patient breastfed for one year and then began to pursue fertility in 2004. She had an elevated day 3 FSH (12 mIu/mL) in September, 2006. She completed two additional cycles of COH/IUI cycles prior to proceeding to IVF/ Intracytoplasmic Sperm Injection (ICSI) treatment. She received 7195 IU of gonadotropins with a GnRH antagonist protocol. On October 12, 2006 three ova were retrieved. Post wash semen sample revealed 14 million spermatozoa/mL, with 35% progressive motility, with < 5% normal morphology. ICSI was performed on two metaphase-2 oocytes (the third oocyte was atretic). One two-pronuclear embryo was observed 18hrs post-ICSI. The embryo was cultured in Life Global medium with 5% Serum Substitute Supplement (SSS, Irvine Scientific, Cat #99193) and 3% Human Serum Albumin (HSA, Irvine Scientific, Cat#9988). One four-cell good quality embryo was transferred following assisted hatching (with acid Tyrode's solution) 47 hours post ova retrieval. RESULTS: The patient's serum hCG level was 120 mIU/ml on 10/26/2006, twelve days after embryo transfer. On 12/04/2006, at 9 weeks 3 days gestation, a transvaginal ultrasound confirmed a triamniotic/monochorionic triplet pregnancy, each with fetal cardiac activity. The patient subsequently delivered monozygotic female triplets on May 20, 2007 at 33 weeks and 3 days gestation via cesarean section. All three infants were eventually discharged in good condition and have had no identifiable neurological or physical abnormalities. CONCLUSIONS: To our knowledge, this is the first known case of viable triamniotic/monochorionic triplet pregnancy following a single embryo transfer in IVF-ET.
Search from 250 M+ research papersSearch from 250 M+ research papers
Open Access
Mar 31, 2023
Joohyeong Lee + 7
